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ATLANTA — Georgia will wait until the November elections before implementing President Obama’s health care overhaul after the U.S. Supreme Court found it largely constitutional, Republican Gov. Nathan Deal said Thursday.

An opponent of the sweeping health care changes, Deal is hoping that Republican Mitt Romney wins the White House and the GOP keeps its House majority and wins the Senate, putting the Republicans in a position to repeal or gut the law. Deal signaled he was in no rush to implement it even as Democrats called on him to quickly move forward.

“We are probably just going to be in a holding pattern until such time as we see what the events of November bring us,” Deal told reporters during a Capitol news conference.

His stance foreshadows the practical difficulties the Obama administration faces implementing its signature domestic policy in the middle of a presidential campaign.

While the nation’s top court generally found in favor of the law, it faces staunch resistance from Republican state officials tasked with turning that law into reality. With Republicans stymied in the courts, GOP leaders could choose to drag their feet in implementing it.

The decision sets up a political dilemma for Deal, who voted against the health care proposal as a congressman before running for governor. Up for re-election in two years, Deal faces a conservative base of voters who oppose the law’s requirement that almost all Americans buy health insurance or face a tax penalty. At the same time, Deal said the court’s ruling leaves him with limited discretion — a measured stance that could upset die-hard conservatives.

“I’d like him to say I’m not going to follow it, but I don’t think that’s going to happen,” said Debbie Whelchel, 49, of Suwanee, an opponent of the law who joined a small tea party rally at the Capitol just before the court ruled. “That’s what I would like to see happen. Honestly, I’m so disappointed.”

Georgia’s leaders were noncommittal on two of the largest health care-related decisions they face.

State officials must tell the federal government by Nov. 16 whether Georgia will run required health information exchanges —networks allowing residents to purchase approved plans under the law — or let the federal government do it. The state could also decide to manage some parts of the exchange but not others. That decision must be made just days after the presidential election, and Deal said his administration may ask for an extension until state lawmakers return in January.

Deal was noncommittal on whether Georgia would expand its Medicaid program, a government-funded health care system that serves the needy, aged, blind, disabled and poor families with children. The Supreme Court’s ruling struck down part of the law that required states to expand the program or lose their federal Medicaid funding. Now that choice is voluntary. If Georgia makes such an expansion, Deal’s administration estimates 620,000 people would join the government-run health plan in 2014. Over a decade, it would cost the state government an estimated $4.5 billion in additional expenses.

Democratic lawmakers called the ruling a victory and urged Republicans like Deal to put the law into action. Democratic state Sen. Vincent Fort said small-government ideology has not stopped Republicans from taking cash from the Obama administration before. For example, former Republican Gov. Sonny Perdue accepted federal stimulus funds despite political misgivings. Georgia cut money from its state budget during the recession, but the stimulus funding meant those cuts were not as deep as they could have been.

“However much they whined about it, they took the money,” Fort said. “And that’s what they ought to do. Be responsible. There are Georgians in a time of economic crisis that we’re in today, we need Gov. Deal and the Republicans to stand up, be responsible, make sure that more Georgians get health care, that Medicaid is expanded in a responsible way.”

Georgia’s Congressional Republicans immediately denounced the ruling, promising to repeal it. Rep. Jack Kingston wrote on Twitter to rebuke Chief Justice John Roberts, an appointee of Republican President Georgia W. Bush who voted with the majority to back the law.

“I feel like I just lost two great friends: America and Justice Roberts,” Kingston said.

Others like Rep. Tom Graves asked their supporters for political donations, saying only the ballot box can undo the court’s ruling.

“A full repeal of this law is now our only option, but that can only happen if we elect more conservatives to the U.S. House, U.S. Senate, and Mitt Romney as the President of the United States,” Graves told supporters in an email.

Democratic Rep. John Barrow, who voted against the health care law, is running for re-election and walked a middle-of-the-road line.

“We have to cut spending and cut health costs, but its starts with rejecting the false choice being offered by both parties, that it’s all or nothing,” Barrow said.